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Individual

ELISE VADER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
919 LOCKE ST, SAN ANTONIO, TX 78208-2127
(210) 358-8255
(210) 644-8726
Mailing address
PO BOX 734812, DALLAS, TX 75373-4812
(210) 358-9500
(210) 358-9183

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA09491
TX

Other

Enumeration date
12/29/2014
Last updated
02/10/2021
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